Examination of the sexually assaulted child

Abstract

Sexual assault on the child has been accepted as one of greatest crimes in the World In case of a sexually attacked child appliying to the health center the prior management must be protecting the physical and psychological health of the child Clinical and other nbsp;examinations have to be performed immediately and the medicolegal report should also be prepared as soon as possible It cannot be forgotten that nbsp; the medicolegal report substantially supports the subject being sexually assaulted Finally it is the proof that reflects the intensity of the event and it rsquo;s wickedness From this perspective the medicolegal report has to cover all findings related to events In this paper the rules of the sexually assaulted child examination the appropriate environment for the examination the qualification of examiners and the obligatory procedures performed by physicians before during and after the examination are stated Turk Arch Ped 2011; 46: 104 10

Keywords

• -

Cinsel saldırıya uğramış çocuğun muayenesi

Öz

Çocu¤a cinsel sald›r›, insana yönelik suçlar içinde en a¤›rlar›ndan birisi olarak de¤erlendirilmektedir. Cinsel sald›r› ma¤duru çocu¤un sa¤l›k kurulufluna baflvurusunda öncelik çocu¤un beden ve ruh sa¤l›¤›n› korumak olmal›d›r. Mümkün olan en k›sa sürede muayenesi yap›lmal› ve adli raporu düzenlenmelidir. Unutulmamal›d›r ki adli rapor cinsel sald›r› suçundan ma¤dur olmufl kifliye yarg›lama aflamas›nda en büyük katk›y› sa¤layacakt›r. Sonuç olarak olay›n fliddetini, yaflatt›¤› örselenmeyi belirtecek olan en önemli belgedir. Bu aç›dan adli rapor, cinsel suç olgular›nda durumu aç›klayan bulgular›n tümünü içermelidir. Bu yaz›da cinsel sald›r›ya u¤ram›fl olan çocuklar›n muayenesinde, muayene ortam›, muayene yapacak ekibin niteli¤i, hekimin muayeneden önce, muayene s›ras›nda ve sonras›nda yapmas› gereken ifllemler belirtilmifltir.

Anahtar Kelimeler

• Cinsel saldırı
• çocuk
• muayene

References

1. Polat O. Tüm boyutlarıyla çocuk istismarı. Ankara: Seçkin yayıncılık, 2007.
2. Celbis O, Karaca M, Özdemir B, Isır AB. Cinsel suçlarda muayene. Harran Tıp Fak Der 2004; 1: 48-52.
3. Celbiş O. Çocukların adli tıbbi muayenesi. İçinde: Yakıncı C, Selimoğlu MA (eds). Çocuk hastalıklarında klinik tanı. Adana: Nobel kitabevi. 2009: 421-34.
4. Polat O. Klinik Adli Tıp. Ankara: Seçkin yayıncılık, 2009.
5. Leventhal JM. Epidemiology of sexual abuse of children: old problems, new directions. Child Abuse Negl 1998; 22: 481-91.
6. Miringoff ML, Opdycke S. America's social health: putting social issues back on the public agenda. New York: ME Sharpe Inc, Armonk, 2008: 106-7.
7. Soysal Z, Eke M. Cinsel saldırı. İçinde: Soysal Z. Adli Obstetrik/Jinekoloji. Cilt II. İstanbul: Adli Tıp Kurumu Yayınları- 9, 2003: 1089-164.
8. Finkelhor D. The international epidemiology of child sexual abuse. Child Abuse Negl 1994; 18: 409-17.

9. Finkelhor D. Current information on the scope and nature of child sexual abuse. Future Child 1994; 4: 31-53.
10. Bolen RM, Scannapieco M. Prevalance of child sexual abuse: A corrective metanalysis. Social Service Review 1999; 73: 281-313.
11. Eskin M, Kaynak-Demir H, Demir S. Same-sex sexual orientation, childhood sexual abuse, and suicidal behavior in university students in Turkey. Arch Sex Behav 2005; 34: 185-95.
12. Alikasifoglu M, Erginoz E, Ercan O, Albayrak-Kaymak D, Uysal O, Ilter O. Sexual abuse among female high school students in Istanbul, Turkey. Child Abuse Negl 2006; 30: 247-55.
13. Koten Y, Tuğlu C, Abay E. Üniversite öğrencileri arasında ensest bildirimi. Ankara: XXXII. Ulusal Psikiyatri Kongresi bildiri özetleri kitabı, 1996; 154.
14. Eckert OL, Sugar N, Fine D. Factors impacting injury documentation after sexual assault. Role of examiner experience and gender. Am J Obstet Gynecol 2004; 190: 1739-43.
15. Adams JA. Guidelines for medical care of children evaluated for suspected sexual abuse: an update for 2008. Curr Opin Obstet Gynecol 2008; 20: 435-41.
16. Bernet W. Child maltreatment. In: Sadock BJ, Sadock VA, (eds). Kaplan and Sadock’s Comprehensive Textbook of Psychiatry. 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2000: 287-9.
17. Macan M, Uvodic P, Botica V. Paternity testing in case of brothersister incest. Croat Med J 2003; 44: 34-79.
18. Tamura A, Tsuji H, Miyazaki T, et al. Sibling incest and formulation of paternity probability: case report. Leg Med (Tokyo) 2000; 2: 189-96.
19. Ovayolu N, Uçan Ö, Serindağ S. Çocuklarda cinsel istismar ve etkileri. Fırat Sağlık Hizmetleri Dergisi 2007; 2: 13-22.
20. Topcu S. Cocuk ve gençlerin cinsel istismarı. Ankara: Doruk yayımcılık, 1997: 43-86.
21. Celbis O, Ozcan ME, Ozdemir B. Paternal and sibling incest: a case report. J Clin Forensic Med 2006; 13: 37-40.
22. Summit RC. The child sexual abuse accommodation syndrome. Child Abuse Negl 1983; 7: 177-93.
23. McGregor K, Jülich S, Glover M, Gautam J. Health professionals' responses to disclosure of child sexual abuse history: female child sexual abuse survivors' experiences. J Child Sex Abus 2010; 19: 239-54.
24. Gerber P, Coffman K. Nonaccidental head trauma in infants. Childs Nerv Syst 2007; 23: 499-507.
25. Polat O. Adli tıp. İstanbul: Der yayınevi, 2000: 207-32.
26. Enos WF, Beyer JC. Examination of the rape victim. Med Leg Bull 1984; 33: 1-6.
27. Cantón-Cortés D, Cantón J. Coping with child sexual abuse among college students and post-traumatic stress disorder: The role of continuity of abuse and relationship with the perpetrator. Child Abuse Negl 2010 Jun 1.
28. Lalor K, McElvaney R. Child sexual abuse, links to later sexual exploitation/high-risk sexual behavior, and prevention/treatment programs. Trauma Violence Abuse 2010; 11: 159-77.
29. Lauber A, Souma ML. Use of toluidine blue for documentationof traumatic intercourse. Obstet Gynecol 1982; 60: 644-8.
30. McCauley J, Guzinski G, Welch R, Gorman R, Osmers F. Toluidine blue in the corroboration of rape in the adult victim. Am J Emerg Med 1987; 5: 105-8.
31. Slaughter L, Brown CR, Crowley S, Peck R. Patterns of genital injury in female sexual assault victims. Am J Obstet Gynecol 1997; 176: 609-16.
32. Lenahan LC, Ernst A, Johnson B. Colposcopy in evaluation of the adult sexual assault victim. Am J Emerg Med 1998; 16: 183-4.
33. Teixeria WR. Hymenal colposcopic examination in sexual offences. Am J Forensic Med Pathol 1981; 2: 209-15.
34. Laraque D, Demattia A, Low C. Forensic child abuse evaluation: a review. Mt Sinai J Med 2006; 73: 1138-47.